By Dr. Mercola
While technology is one of my primary passions, I have concerns about many of the technological solutions offered by the medical industry.
A case in point is a new machine approved by the FDA last year called miraDry. It's basically a microwave gun (utilizing 5800 MHz wavelength energy) that radiates the sweat glands in your armpits, thereby destroying them. This effectively shuts down sweat production in the treated area.
This would superficially appear to be a wonderful new tool to eliminate what would seem to be one of life's major challenges, how to eliminate body odor from underarm sweating.
Sweating is normal, of course, and serves very important functions, including cooling your body and eliminating toxins. But a tiny minority of people (an estimated three percent) suffer from hyperhidrosis, or excessive sweating, which can lead to social awkwardness and embarrassment.
A common treatment is Botox injections – another potentially risky alternative – which is typically covered by health insurance. MiraDry treatments are not covered, and at a cost of about $3,000 for a two-session treatment, it's definitely not an inexpensive option.
This new device indeed does appear effective, but at what cost in terms of health?
In two treatments, the device is said to destroy 22,000-30,000 underarm sweat glands (which equates to about two percent of your body's total sweat glands), reducing sweat volume by an average of 82 percent.
The effect, is not necessarily permanent, however. According to David Pariser,1 a professor at Eastern Virginia Medical School, it's still not known whether your body might compensate for the lost sweat glands under your arms by increasing sweat production through the glands over the rest of your body.
Is the MiraDry Device an Ideal Option to Reduce Sweating?
According to the FDA, the miraDry system2 is "a microwave device designed to heat tissue located at the dermal-hypodermal interface where the sweat glands reside using a surface contact applicator." Of concern is the fact that the study conducted to test its efficacy and safety contained only 120 people.
According to The Wall Street Journal:3
"A company-funded study of 120 adults with hyperhidrosis published earlier this year in the journal Dermatologic Surgery, measured the effect of two treatment sessions, with a third allowed as needed if patients hadn't seen improvement.
A month after the final treatment, 89 percent of those treated with miraDry had a treatment success, defined as sweat reduced to 'never noticeable' or 'tolerable.' By comparison, 54 percent of those who got a control treatment without the microwave energy saw a treatment success."
While efficacy was shown, the approval of the system is primarily based on "substantial equivalence" with another device, called DTS G2,4 which is "indicated for use for coagulation of soft tissue," basically an electrosurgical cutting and coagulation device.
According to some sources, such as a Cigna5, there's very little evidence in the in the published, peer-reviewed scientific literature to support the use of microwave radiation for the treatment of hyperhidrosis.
Despite a myriad of unanswered questions, miraDry has received positive write-ups in The Wall Street Journal6 and the Huffington Post.7 But is it really wise to eliminate sweat glands? What are the side effects of a.) microwaving your armpits, and b.) eliminating sweat glands? No one really seems to know what the potential long-term side effects might be as of yet, but I'm willing to bet there are some.
According to The Wall Street Journal:8
"MiraDry, in addition to reducing sweat volume, kills apocrine glands, which cause odor, and damages hair follicles, resulting in sparser armpit hair... After the procedure, the underarms are swollen and tender for a week. Most people have minor swelling, but in some cases it can be a lump as big as a softball, says Dr. Shamban; the swelling is treated with steroids.
Another side effect can be temporary numbness and tingling in the arm. A patient in one study, however, had muscle weakness in the left arm; it was improving when the patient was last seen six months after the procedure. To reduce risk of nerve damage, Miramar recommends doctors use the lowest energy setting in the upper part of the underarm, where nerves are closest to the surface."
Concern of numbness in the arm is echoed in the following online testimonial9:
"I had my first miraDry treatment two weeks ago. The device was set to level 2. I had 55 lidocaine shots in each underarm which were fairly uncomfortable but manageable. Underarm sweat has drastically been reduced although not 100%...
The procedure itself was virtually painless EXCEPT one instance which was extremely painful and alarming. I'm convinced it damaged the Ulnar nerve in my right arm. I have a constant numb tingling soreness on the underside of my forearm from my elbow to my wrist. This has not improved at all since two days after the treatment. My left arm is fine...
Very little information is available as this is such a new procedure. I've read the official FDA documentation on clinical trials, and the side effects on subjects was vague and follow ups were minimal. I'm getting increasingly concerned since there has been no real improvement and I'm fearful of permanent nerve damage."
Why is Treatment for Extremely Rare Condition "Mass Marketed" by Conventional Media?
One potential problem I see here is misuse by folks who might not have a severe enough case of hyperhidrosis to justify such dramatic intervention. A lot of people just don't like to deal with normal sweating. This concern is augmented by major media comments such as the opening line by The Wall Street Journal, reporting on the treatment:
"During one of the hottest summers in recorded history comes a new way to never let them see you sweat: Microwave your sweat glands."
Sounds more like an advertisement than a public health related news report, doesn't it? While the article goes on to specify that the treatment is for hyperhidrosis, it already planted the seed in the average person's mind that this could be a viable alternative for avoiding the hassle of sweating as a normal response to hot weather. Hyperhidrosis actually appears to be (at least in part) a response to anxiety as opposed to an excessive response to temperature. The Huffington Post mentions this in relaying the personal story of Jessica Winter:
"In a piece featured on Oprah.com, Jessica Winter wrote she sweat so much during cocktail parties that she tried Chinese herbs and Botox, but found that the only effective solution was to pop a Xanax to calm herself down. She eventually spoke with a therapist after realizing that her own sweating was rooted in anxiety."
Why Do You Sweat, and is it Really Necessary?
You have two different types of sweat glands: Eccrine sweat glands, which are distributed over your entire body, and apocrine sweat glands, located on your scalp, armpits, and genital area. While abhorred by many, sweating actually has numerous health- and beauty-related benefits. Your skin is the largest organ of your body, and serves important roles just like any other bodily organ. For example, sweating helps your body:
- Maintain proper temperature and keep you from overheating
- Expel toxins, which supports proper immune function and helps prevent diseases related to toxic overload, such as fibromyalgia and even cancer
- Kill viruses and bacteria that cannot survive in temperatures above 98.6 degrees Fahrenheit
- Clean the pores, which will help eliminate blackheads and acne
Interestingly, profuse sweating can actually help decrease body odor. Foul body odor is related to the toxins being expelled – it's not your "natural" scent. If you're living a "clean" lifestyle, meaning a lifestyle in which you're minimally exposed to dietary and environmental toxins and therefore have a low toxic burden, your sweat will be close to odorless.
Typically, your body will sweat in response to an internal rise in temperature, whether caused by exercise or being in the sun on a hot day. However, sweating can also be the result of a faulty neurological response, related more to mental or emotional stress than proper temperature control. Anxiety can cause a number of neurological symptoms, such as dizziness, headache, hyperventilation, trembling, and sweating.
A FAR Safer Way to Remove Armpit Body Odor
As you can see, sweat glands have many important functions and removing them with destructive types of techniques like the one described in the featured article can potentially be a prescription for disaster. Similarly, it would be equally unwise to suppress the sweat with aluminum antiperspirants as I more fully discuss in this article on the dangers from using antiperspirants. One of the best strategies that I have found to SAFELY address this and actually increase your health would be to suntan your armpits. I realize this is not practical for most people, but I had an opportunity to try it. I did it primarily for cosmetic purposes.
I haven't used antiperspirants for over 30 years but rather wash my armpits with soap and water. But when I exposed my armpits to 30-60 minutes of regular sunshine, I noticed that I no longer needed to use soap in my armpits for odor control. Apparently the ultraviolet rays are able to sterilize the bacteria in the armpit that cause the odor. I encourage you to try the experiment, just be careful not to burn your armpits. You can also use an approved tanning bed if appropriate sunlight exposure is not readily available.
Important to Treat the CAUSE of the Problem
In Jessica's case above, the increased sweating was a result of her body responding adversely to stress. So rather than destroy useful sweat glands with cool new microwave technology, it is important to understand that your sweat glands indeed provide a benefit. It makes far more sense to address the underlying cause. If you disagree with this then you might be the type of person who would also prefer smashing the warning lights on your car's dashboard when they light up instead of addressing the reason for the warning.
Obviously most rational people would not destroy the idiot lights as they would appreciate that they are valid and important signals and that the car is communicating that there's some problem that needs to be addressed. Destroying the lights or disabling them does simply NOT solve the problem, and even worse, could lead to catastrophic failure down the road, if ignored.
Most pain your body serves a similar valuable function. I encourage people to be very grateful for any pain they have as it is phenomenal feedback that tells you something in your life needs to be adjusted to remove that pain. If you make the mistake and suppress it with drugs or surgery, and fail to address the underlying cause, you are simply inviting a health disaster.
The same is also true for "classic" heart risk factors like elevated total cholesterol, for which one in every four adults over the age of 45 in the US now take statin drugs, completely failing to address the underlying cause. By failing to improve their cholesterol ratios by adjusting their diet and exercise, they fail to address the underlying biochemical signaling that typically results in insulin and leptin resistance, and thus they paradoxically actually increase their risk for not only heart disease but cancer.
So, if you struggle with persistent excessive sweating, before you rush to shut down your body's thermal regulation processes, it would probably be wise to employ some non-invasive techniques to address any underlying psychological factors first. I would recommend trying the Emotional Freedom Technique (EFT) – a simple and non-invasive energy psychology tool that can help address unresolved emotional trauma causing anxiety or stress.
Other Questionable Tech Advances
The miraDry device is just one example of technological advances and body treatments that might not be good for you. Other similar examples include:
- CoolSculpting,10 which kills fat cells under the skin by freezing them to the point of elimination. Once crystallized, they die and are eliminated from your body.
- Laser hair removal. While popular, it's important to realize laser hair removal is not a risk free endeavor.11 Common side effects include pain, swelling, skin irritation, hyper pigmentation, burns, infection, scarring and other changes in skin texture.12,13
Be aware that some states do not require any kind of licensing to perform laser hair removal, and in inexperienced, untrained hands, you're far more likely to suffer more serious side effects,14 including permanent disfigurement.
- Bikini (and body) waxing. Last month, a family physician called for an end to the "war on pubic hair," claiming the practice of removing pubic hair increases risks of infection and sexually transmitted diseases. As reported by The Independent:15
"As director of the health centre at Western University in Washington State, US, she has seen the consequences. 'Pubic hair removal naturally irritates and inflames the hair follicles, leaving microscopic open wounds. Frequent hair removal is necessary to stay smooth, causing regular irritation of the shaved or waxed area. When that is combined with the warm, moist environment of the genitals, it becomes a happy culture media for some of the nastiest bacterial pathogens.'...
In her practice it is not unusual to find patients with boils and abscesses on their genitals from shaving as well as cellulitis, an infection of the scrotum, labia or penis from shaving or from having sex with someone infected. Herpes is also an increased risk 'due to the microscopic wounds being exposed to virus carried by mouth or genitals.' 'It follows that there may be vulnerability to the spread of other sexually transmitted diseases as well,' she says.
'Pubic hair does have a purpose, providing a cushion against friction that can cause skin abrasion and injury, and protection from bacteria. It is the visible result of adolescent hormones and certainly nothing to be ashamed of or embarrassed about.'"
The hairless ideal sought by so many people is in truth both unattainable and probably not entirely healthful. Body hair will always grow back (even laser hair removal will only subdue hair growth and thickness by 50 percent or so with repeated treatments), and each time you remove the hair you're causing some damage to your skin. Hair does serve important functions, such as:
- Protection: preventing the foreign particles like dust to enter your body
- Temperature control: hair captures the air surrounding your body to reduce the loss of heat
- Reduces friction, which prevents skin irritation
- Promotes touch reception
Likewise, the converse ailment to hyperhidrosis (excessive sweating) is anhidrosis, where little or no sweat is produced. This, contrary to hyperhidrosis, is actually a life threatening condition in hot weather, as your body cannot cool itself without well-functioning sweat glands. Granted, eliminating two percent of your body's sweat glands by zapping your armpits probably will not put you in an immediately life threatening position. But I still believe it would be wise to exhaust all other possibilities – including addressing any potential psychological factors such as anxiety – before resorting to destroying sweat glands with microwave radiation.
After all, microwave radiation (300 MHz to 300 GHz) has been found to cause a number of health problems, including DNA damage and cancer – issues that the miraDry makers may not have not studied. Personally, I'm concerned the miraDry treatment might spur future cancer growth, especially since your armpit also houses a number of lymph nodes.